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"The first thing she said to me was, 'I know it's a girl, and I need your help to get it out of me.' "

Dr. Carpenter's brow furrowed as she told me about the first time she met Priya. Carpenter was an OB-GYN resident at the time. Priya was a recent immigrant from India who worked as a manager in a retail store and had come to the central California clinic on her lunch break. Punctuating her story with glances at her watch, she told Carpenter how, one week earlier, she had used another lunch break to go to a private ultrasound clinic, where she learned that she was pregnant with a girl. With her arms tightly crossed along her abdomen, she explained that her husband and his parents expected a boy, and that Carpenter's help could change her life.

"I have a daughter," Priya said. "I don't need another one."

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Mara Hvistendahl's new book Unnatural Selectionhas sparked animated conversations about the frightening global consequences of sex selection, or the use of medical technology to ensure the birth...